Kangasniemi Mari, Hirjaba Marina, Kohonen Katja, Vellone Ercole, Moilanen Tanja, Pietilä Anna-Maija
Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Department of Nursing, The School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland.
J Clin Nurs. 2017 Sep;26(17-18):2583-2592. doi: 10.1111/jocn.13642. Epub 2017 Mar 12.
To describe cardiac patients' perceptions of their responsibilities in adherence to care.
The responsibilities of cardiac patients' adherence to care is a topical issue because of the increasing prevalence of noncommunicable diseases in Western countries, including cardiovascular disease (CVD). Responsibilities for cardiac patients' care have been studied, but little is described about patients' perspectives in this study.
A qualitative, hermeneutic inquiry.
We used face-to-face individual semistructured interviews with 21 cardiac patients (76% male) aged 58-86 in an urban area of Finland in winter 2013. The data were analysed hermeneutically with inductive content analysis.
Based on our results, patients with cardiac disease understood that autonomy provided a basis for their responsibility in adherence to care. It included being able to make independent decisions, in collaboration with health professionals, or even to entrust that responsibility to healthcare professionals. Responsibilities were understood to be an expression of adherence, perceived to benefit the patient and included the duty to adopt a healthy lifestyle and care for their own medical condition. The main factors that influenced patients' responsibilities around adherence to care were their individual resources and motivation, relationships with healthcare professionals and the resources of the healthcare system.
Autonomy is an inherent part of cardiac patients' adherence to care, but there has been little focus on their responsibilities in the literature. More attention needs to be paid to the healthcare providers' abilities to support patients' duties and responsibilities in clinical practice and to future research.
描述心脏病患者对自身在坚持治疗方面责任的看法。
由于西方国家包括心血管疾病(CVD)在内的非传染性疾病患病率不断上升,心脏病患者坚持治疗的责任是一个热门话题。关于心脏病患者治疗责任的研究已有不少,但本研究中对患者观点的描述较少。
一项定性的诠释学探究。
2013年冬季,我们在芬兰一个城市地区对21名年龄在58 - 86岁的心脏病患者(76%为男性)进行了面对面的个人半结构式访谈。采用归纳性内容分析法对数据进行诠释学分析。
根据我们的研究结果,心脏病患者明白自主性为他们坚持治疗的责任提供了基础。这包括能够与医疗专业人员合作做出独立决策,甚至将该责任委托给医疗专业人员。责任被理解为坚持治疗的一种表现,被认为对患者有益,包括采取健康生活方式和照顾自身病情的义务。影响患者坚持治疗责任的主要因素包括他们的个人资源和动机、与医疗专业人员的关系以及医疗系统的资源。
自主性是心脏病患者坚持治疗的固有组成部分,但文献中对他们的责任关注较少。在临床实践中,需要更多地关注医疗服务提供者支持患者责任的能力以及未来的研究。